In this study, we test to what extent negative outcomes of depression reported in different countries may be confirmed in a Southern European population.
Methods:
This is a follow-up (mean 4.5 years) of the elderly sample interviewed in the baseline of the Zaragoza Study (or ZARADEMP 0). The general methodology is described in the previous paper. The same two-phase procedure completed at baseline was also implemented at follow-up and the same standardized instruments were used. Cases of depression at follow-up were diagnosed with AGECAT criteria. Operational criteria were also used for definition of both incident case of depression and chronic case of depression.
Results:
Six hundred and sixty three elderly (61.4%) were reassessed at follow-up, and216 died in the follow-up period. A negative outcome of both, major and minordepression was observed. Taken together, the pessimistic outcome (death, chronicity or conversion to other psychiatric diagnosis) was observed in 70.5% of cases of depression, but only in30.8% of non-cases, the differences being statistically significant (Z = 6.7; p < 0.001).Similarly, a high proportion of subcases of depression had a negative prognosis (48.5%),the differences with non-cases also being statistically significant (Z = 2.7; p < 0.005). Incidence rate of depression was 14.4 (95% C.I. 11.0-18.6) the rate being significantly higher in women when compared to men.
Conclusions:
This is the first report of a negative outcome of depression in a representative sample of the elderly in a Southern European city. Subcases of depression also had a negative outcome. The clinical significance in AGECAT cases of depression is emphasized (AU)